Prevalence of autoantibodies to autonomic nervous tissue structures in Type 1 diabetes mellitus

Diabet Med. 1999 Jul;16(7):544-9. doi: 10.1046/j.1464-5491.1999.00092.x.


Aims: The pathogenesis of diabetic autonomic neuropathy is multifactorial, but recent studies have suggested a link between the presence of autoantibodies to nervous tissue structures and severe, symptomatic autonomic neuropathy. The present study was designed to examine the true prevalence of these autoantibodies in a large clinic-based population of Type 1 diabetic patients compared to nondiabetic controls.

Methods: The presence of complement fixing autoantibodies to vagus nerve (CF-VN), sympathetic ganglion (CF-SG) and adrenal medulla (CF-ADM) was assessed by immunofluorescence in a large cohort of patients (n = 394) of varying duration of Type 1 DM (median 28 years, range 6 months to 73 years) and 160 age and sex-matched nondiabetic control subjects.

Results: All three autoantibodies were frequently detected in Type 1 DM (CF-VN, 22.1%; CF-SG, 30.7%; CF-ADM, 13.2%) but only rarely in healthy control subjects (4.4%, 4.4% and 3.1%, respectively; P < 0.0005 for all). There was no association between any of the autoantibodies and retinopathy (fundoscopy), peripheral somatic neuropathy (biothesiometry) or nephropathy (urinary albumin-creatinine ratio).

Conclusions: Our results on this large cohort establish the extensive presence of autonomic nervous tissue autoantibodies in Type 1 DM. Their role in reflecting, causing or predicting autonomic neuropathy remains to be determined.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Medulla / immunology
  • Adult
  • Aged
  • Autoantibodies / blood*
  • Autonomic Nervous System / immunology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Complement Fixation Tests
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Neuropathies / immunology
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Ganglia, Sympathetic / immunology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Reference Values
  • Vagus Nerve / immunology


  • Autoantibodies